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http://dx.doi.org/10.23736/S0026-4946.17.04845-9DOI Listing

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Article Synopsis
  • β-Lactams like penicillins can trigger allergic reactions, with a rare condition called symmetric drug-related intertriginous and flexural exanthema (SDRIFE) highlighted in a case involving a 65-year-old male patient.
  • The patient developed blue-purple pigmentation in specific body areas after taking amoxicillin/clavulanic acid and reported similar reactions following previous antibiotic use, leading to a diagnosis of SDRIFE.
  • Treatment included topical corticosteroids and antihistamines, and it's crucial for the patient to discontinue use of the antibiotic to avoid future reactions.
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Background: Antibiomania is a rare but recognized side effect with yet unclear definite pathogenesis although multiple hypotheses have been proposed. The novelty of this case is the suspected pharmacodynamic drug-drug interaction between clarithromycin and amoxicillin-clavulanic acid.

Case Presentation: We present the occurrence of a brief manic episode concerning a 50-year-old man with no psychiatric history, first started on amoxicillin-clavulanic acid therapy and then switched to clarithromycin for left basal pneumonia.

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Anaphylaxis is a severe acute multisystem syndrome involving massive mediator release from mast cells and basophils. Although the entire arterial system can be affected, when coronary arteries are the main targets, Kounis syndrome needs to be considered. Cerebral artery involvement has also been suggested in rarer MC-mediator release episodes; so-called 'Kounis-like' syndrome.

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Amoxicillin/clavulanic acid is one of the widely prescribed antibiotics in the outpatient setting giving excellent antimicrobial coverage and relatively safe profile in terms of adverse reactions. Gastrointestinal and cutaneous reactions are among the commonly reported. Our goal is to describe a case of agranulocytosis induced by amoxicillin/clavulanic acid in a previously healthy patient and review prior reports with similar presentation.

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The Publisher regrets that this article is an accidental duplication of an article that has already been published, https://doi.org/10.1016/j.

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